中国组织工程研究

中国组织工程研究 ›› 2014, Vol. 18 ›› Issue (31): 4939-4943.doi: 10.3969/j.issn.2095-4344.2014.31.004

• 人工假体 artificial prosthesis • 上一篇    下一篇

保留髌骨型全膝关节置换修复退变性骨关节炎：髌软骨退变等级对疗效的影响

徐  超1，侯彦杰1，伊力哈木•托合提1，关振鹏2，李山珠1，王  鑫1   

  1. 1新疆医科大学第二附属医院骨科，新疆维吾尔自治区乌鲁木齐市 830000；2北京大学人民医院关节科，北京市  100044
  • 收稿日期:2014-06-04 出版日期:2014-07-23 发布日期:2014-07-23
  • 通讯作者: 伊力哈木?托合提，博士，主任医师，新疆医科大学第二附属医院骨科，新疆维吾尔自治区乌鲁木齐市 830000
  • 作者简介:徐超，男，1978年生，新疆维吾尔自治区乌鲁木齐市人，汉族，新疆医科大学在读硕士，主治医师，主要从事关节，运动医学，创伤和脊柱研究。
  • 基金资助:

    新疆维吾尔自治区科技支疆项目计划项目(200991265)

Total knee arthroplasty without patellar resurfacing for degenerative osteoarthritis: effects of patellar chondromalacia on clinical outcomes

Xu Chao1, Hou Yan-jie1, Yilihamu•Tuoheti1, Guan Zhen-peng2, Li Shan-zhu1, Wang Xin1   

  1. 1Department of Orthopedics, Second Affiliated Hospital, Xinjiang Medical University, Urumqi 830000, Xinjiang Uygur Autonomous Region, China; 2Department of Joint, People’s Hospital, Peking University, Beijing 100044, China
  • Received:2014-06-04 Online:2014-07-23 Published:2014-07-23
  • Contact: Yilihamu?Tuoheti, M.D., Chief physician, Department of Orthopedics, Second Affiliated Hospital, Xinjiang Medical University, Urumqi 830000, Xinjiang Uygur Autonomous Region, China
  • About author:Xu Chao, Studying for master’s degree, Attending physician, Department of Orthopedics, Second Affiliated Hospital, Xinjiang Medical University, Urumqi 830000, Xinjiang Uygur Autonomous Region, China
  • Supported by:

    the Science and Technology Support Project in Xinjiang Uygur Autonomous Region, No. 200991265

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摘要：

背景：全膝关节置换中是否置换髌骨以及髌骨软骨对疗效的影响还存在争议。
目的：评价膝关节退变性骨关节炎行保留髌骨型全膝关节置换后膝前痛发生率、临床功能及髌骨软骨退变等级对临床疗效的影响。
方法：回顾分析2008年6月至2010年2月采用保留髌骨型全膝关节置换治疗162例(162膝)膝关节退变性骨关节炎患者的临床资料。髌骨软骨退变等级采用Outerbridge 分级标准、置换后膝前痛采用目测类比评分评分、临床功能采用美国膝关节学会评分和髌骨评分。
结果与结论：所有患者切口达Ⅰ期愈合。髌骨软骨退变等级：Ⅰ级18例；Ⅱ级36例；Ⅲ级62例；Ⅳ级35例。末次随访时，6例(4.0%)患者有膝前疼痛，其中轻度疼痛4例，中度2例，无重度疼痛。患者平均美国膝关节学会、髌骨评分均明显提高。髌骨软骨退变等级不影响置换后膝前痛发生率(χ2=0.42, P=0.94)、美国膝关节学会评分(膝评分：F=1.83，P=0.14；功能评分：F=0.56，P=0.64)和髌骨评分(F=0.78，P=0.51)。说明膝关节退变性骨性关节炎行保留髌骨型全膝关节置换可取得满意的临床疗效，髌骨软骨退变等级不影响临床疗效。


中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程


全文链接：

关键词: 植入物, 人工假体, 膝关节, 骨性关节炎, 关节成形, 膝前痛, 髌骨置换, 全膝关节置换

Abstract:

BACKGROUND: There remains controversy that whether patellar resurfacing in total knee arthroplasty and whether patellar chondromalacia has influence on clinical outcomes.
OBJECTIVE: To evaluate anterior knee pain, clinical function and effects of patellar chondromalacia on clinical outcomes after total knee arthroplasty without patellar resurfacing for degenerative osteoarthritis.
METHODS: Clinical data of 162 patients (162 knees) with degenerative osteoarthritis undergoing total knee arthroplasty without patellar resurfacing from June 2008 to February 2010 were retrospectively analyzed. Outerbridge classification was used for patellar chondromalacia, Visual Analogue Scale for anterior knee pain, and the Knee Society clinical scoring system for clinical function.
RESULTS AND CONCLUSION: The incision of all patients reached stage-I healing. The patellar chondromalacia: grade I in 18 patients, grade II in 36 patients, grade III in 62 patients, and grade IV in 35 patients. At the final follow-up, there were six (4.0%) patients with anterior knee pain, including four cases of mild pain and two cases of moderate pain, no severe pain. The mean Knee Society clinical scoring system scores and patellar score were obviously elevated. Outerbridge classification did not affect the incidence of anterior knee pain after replacement (χ2=0.42, P=0.94), the Knee Society clinical scoring system score (knee score: F=1.83, P=0.14; functional score: F=0.56, P=0.64) and partellar score (F=0.78, P=0.51). These data suggested that total knee arthroplasty without patellar resurfacing for degenerative osteoarthritis can obtain satisfactory clinical outcomes, and the patellar chondromalacia may not affect the clinical outcomes.


中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程


全文链接：

Key words: patella, knee joint, knee prosthesis, arthroplasty, replacement

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